Etiology And Treatment Of Oral Habits

Question 1

Repeated forceful sucking of the digit with associated strong buccal and lip contractions

Answer 1

Digit sucking

Question 2

Digit sucking incidence

Answer 2

No correlation to socioeconomic level
Males=females
50% of 1 year olds
20% of 6-15 year olds

Question 3

Types of sucking

Answer 3

Nutritive
Non nutritive
Chronic

Question 4

Nutritive

Answer 4

Needed to survive

Question 5

Non nutritive

Answer 5

Sucking of a digit or pacifier not related to the ingestion of nutrients
Prevalence 50-70% in the first few years of life
Birth to 4 years old

Question 6

Chronic

Answer 6

Continues after age 4
Distortion of dento-alveolar structures
Stop habit before permanent teeth erupt to avoid side effects

Question 7

What type of malocclusion is associated with digit habits

Answer 7

Class II

Question 8

Possible effects of chronic sucking

Answer 8

Dental
Skeletal

Question 9

Dental effects

Answer 9

Labial inclination / displacement of max incisors
Increased overjet with spacing between maxillary incisors
Over eruption of posterior teeth
Decreased overbite of anterior teeth (anterior open bite)
Linguo-version of mandibular incisors
Posterior crossbite (constricted max arch)
Class II molar relationship

Question 10

Failure of _______ arch to develop in ______ due to alteration in _______ between cheek and _______

Answer 10

Maxillary
Width
Balance
Tongue

Question 11

What must happen to the tongue to accommodate the digit position

Answer 11

Must be lowered

Question 12

Leaving the __________ posterior teeth unopposed on the _________ surface

Answer 12

Maxillary
Lingual

Question 13

Skeletal effects

Answer 13

Lowered mandibular posture and autorotation
Class II apical base relationship
Anterior + superior distortion of max anterior alveolar process

Question 14

What happens maxillary apical base

Answer 14

Distorted and lengthened

Question 15

Other effects

Answer 15

Functional shift to right or left
Asymmetrical growth of condyle or mandibular fossa
Speech problems
TMJ problems= lack of incisal guidance

Question 16

Compensation made necessary by the altered oral environment by an original habit.

Abnormal tongue, perioral and facial muscle posture, and activity during swallowing and/or at rest

Answer 16

Tongue dysfunction

Question 17

Swallowing patterns - visceral

Answer 17

Neonate, infant
Normal until ~4 years old

Question 18

Swallowing patterns -somatic

Answer 18

Adult
Begins with eruption of primary dentition
Normal by age 4 or 5

Question 19

Normal swallowing patterns characterized by

Answer 19

Decreased use of perioral muscles
Teeth and lips being in contact
Tongue remaining within the confines of dental arches

Question 20

Tongue problems may result from

Answer 20

Excessive epipharyngeal lymphoid tissue
Neurological deficit
Large tongue
Skeletal open bite

Question 21

Tongue dysfunction

Answer 21

Primary, causal
Secondary, adaptive
Anterior
Lateral
Complex

Question 22

Horizontal growth pattern with tongue thrust

Answer 22

Bimaxillary dental protrusion

Question 23

Vertical growth pattern with tongue thrust

Answer 23

Lower incisors lingually inclined

Question 24

T/F : it is important to clarify both skeletal and tongue dysfunction

Answer 24

Yes, from a differential dx point of view

Question 25

Lip habits

Answer 25

Lip sucking Cheek sucking or biting

Question 26

Treatment approaches

Answer 26

Decision to treat Chronic non-nutritive sucking or tongue thrusting habits should be based on - is the habit causing or enhancing the malocclusion? -will cessation of the habit allow for self corrrection? -will cessation prevent the malocclusion from worsening or progressing? - is the child mature enough to accept treatment?

Question 27

Child must be aware that there is a problem and desire to stop

Answer 27

Motivational books Band-aid on digit Gloves, socks

Question 28

Infants

Answer 28

Pacifier Decreases occurrence of chronic habit Advantage- parents can limit use

Question 29

Treatment toddlers

Answer 29

No direct dental or social harm Don’t encourage Dont discourage too vigorously Seek reason for its use Distraction

Question 30

Tx preschooler

Answer 30

Encourage toys, games, friends or outdoor activities

Question 31

School age children and older treatment

Answer 31

Habit practices in privacy No spontaneous improvement as permanent teeth erupt Even night time habit practice can perpetuate a dental alveolar problem

Question 32

Behavior modification

Answer 32

Reward Char progress Positive reinforcement Devise a strategy

Question 33

Emotional support

Answer 33

Parent and dentist Reassurance + patience